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GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT
108 Eighth Street, Suite 201
Glenwood Springs, Coloradof 81601
Phone (970) 9454212
INDIVIDUAL SEWAGE DISPOSAL PERMIT
PROPERTY ►}([1 Q��n� {IIr c �F� pn /
Owner's Name J tt�� `vw' !�"�e5%31134th
resent Address ��� dv'�e�f..._� a It-Pie
�n' l S(rp�I a'�} Phone y /6 —��� 1
System Location L t 11344 \ Ue S�►CI S j ' ' -P e Co 2J6s
Permit
4036
Asslessor's Parcel No.
This does not constitute
a building or use permit.
Legal Description of Assessor's Parcel No
SYSTEM DESIGN
rce l d "Vi - I I ( - v a o9 Na -five Sp� � a—
i-
-- Septic Tank Capacity (gallon) Other
Percolation Rate (minutes/inch) Number of Bedrooms (or other)
Required Absorption Area - See Attached
Special Setback Requirements:
Date Inspector
FINAL SYSTEM INSPECTION AND APPROVAL (as installed)
Call for Inspection (24 hours notice) Before Covering Installation
System Installer
Septic Tank Capacity
Septic Tank Manufacturer or Trade Name
Septic Tank Access within 8" of surface
Absorption Area
Absorption Area Type and/or Manufacturer or Trade Name
Adequate compliance with County and State regulations/requirements
Other
Date 1 0) cf/ � s Inspector
RETAIN WITH RECEIPT RECORDS AT CONSTR 51
CONDITIONS: / rfr
1. All installation must comply with all requirements of the Colorado State Board of Health Individual Sewage Disposal Systems Chapter
25, Article 10 C.R.S. 1973, Revised 1984.
2. This permit is valid only for connection to structures which have fully complied with County zoning and building requirements. Con-
nection to or use with any dwelling or structures not approved by the Building and Zoning office shall automatically be a violation or a
requirement of the permit and cause for both legal action and revocation of the permit.
3. Any person who constructs,alters, or installs an individual sewage disposal system in a manner which involves a knowing and material
variation from the terms or specifications contained in the application of permit commits a Class I, Petty Offense ($500.00 f ine — 6
months in jail or both).
INDIVIDUAL SEWAGE DISPOSAL SYSTEM APPLICATION
OWNER Hama -
ADDRESS a/*
CONTRACTOR RC,"
ADDRESS SQiw-4
1
l AIN reettsi do. Cad.
PHONE 874-099/
250, s; C�-
PERMIT REQUEST FOR (✓S NEW INSTALLATION
PHONE 3J9-8896 carr
( ) ALTERATION
( ) REPAIR
Attach separate sheets or report showing entire area with respect to surrounding areas, topography of area, habitable
building, location of potable water wells, soil percolation test holes, soil profiles in test holes (See page 4).
LOCATION OF PROPOSED FACILITY:
Near what City of Town iQ Size of Lot 5. I 1/ ISD
Legal Description or Address 1+1;a2., SDji
WASTES TYPE: (.0/ DWELLING ( ) TRANSIENT USE
( ) COMMERCIAL OR INDUSTRIAL ( ) NON-DOMESTIC WASTES
( ) OTHER—DESCRIBE
Dr, £-j+ 9,-R;Po ,
BUILDING OR SERVICE TYPE: 01 i ( (Q �QM4L' as. ch„, cq
Number of Bedrooms i% 4 ber of Persons Jap 1-2 7
(vf Garbage Grinder (0 Automatic Washer (V`Dishwasher
SOURCE AND TYPE OF WATER SUPPLY: . (WELL ( ) SPRING ( ) STREAM OR CREEK
If supplied by Community Water, give name of supplier:
DISTANCE TO NEAREST COMMUNITY SEWER SYSTEM:
Was an effort made to connect to the Community System?
A site plan is required to be submitted that indicates the following MINIMUM distances:
Leach Field to Well: 100 feet
Septic Tank to Well: 50 feet
Leach Field to Irrigation Ditches, Stream or Water Course: 50 feet
Septic System (septic tank & disposal field) to Property Lines: 10 feet
YOUR INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT WILL NOT BE ISSUED WITHOUT
A SITE PLAN.
GROUND CONDITIONS:
Depth to first Ground Water Table
0
Percent Ground Slope Mint) I /p
TYPE OF INDIVIDUAL SEWAGE DISPOSAL SYSTEM PROPOSED:
( Vl SEPTIC TANK ( ) AERATION PLANT ( ) VAULT
( ) VAULT PRIVY ( ) COMPOSTING TOILET ( ) RECYCLING, POTABLE USE
( ) PIT PRIVY ( ) INCINERATION TOILET ( ) RECYCLING, OTHER USE
( ) CHEMICAL TOILET( ) OTHER -DESCRIBE
FINAL DISPOSAL BY:
(✓S ABSORPTION TRENCH, BED OR PIT ( ) EVAPOTRANSPIRATION
( ) UNDERGROUND DISPERSAL ( ) SAND FILTER
( ) ABOVE GROUND DISPERSAL ( ) WASTEWATER POND
( ) OTHER -DESCRIBE
WILL EFFLUENT BE DISCHARGED DIRECTLY INTO WATERS OF THE STATE? _Nu
PERCOLATION TEST RESULTS: (To be completed by Registered Professional Engineer, if the Engineer does the
Percolation Test)
Minutes per inch in hole No. 1 Minutes 3�
Minutes 30 per inch in hole No. 2
per inch in hole No. 3
Minutes per inch in hole No. _
Name, addressId telephone of RPE w, o made soil absorption tests:
45- 7988 c14.Sodo c
Name, address and telephone of RPE responsible for design of the system:
gtk5-SG 21Q- / ler?91calo /vQ •S 1
ail 1 t, /!: 1"
•0, G ,
Applicant acknowledges that the completeness of the application is conditional upon such further mandatory and
additional tests and reports as may be required by the local health department to be made and famished by the applicant
or by the local health department for purposed of the evaluation of the application; and the issuance of the permit is
subject to such terms and conditions as deemed necessary to insure compliance with rules and regulations made,
information and reports submitted herewith and required to be submitted by the applicant are or will be represented to
be true and correct to the best of my knowledge and belief and are designed to be relied on by the local department of
health in evaluating the same for purposes of issuing the permit applied for herein. I further understand that any
falsification or misrepresentation may result in the denial of the application or revocation of any permit granted based
upon said application and in legal action for perjury as provided by law.
Signed (.t+dI& .�J Date Crilicc, 74hOC
PLEASE DRAW AN ACCURATE MAP TO YOUR PROPERTY!!
16 GLENWOOD SPRINGS, CO
1517 Blake Avenue
Suite 101
Glenwood Springs, CO 81601
970.945.8676 phone
970.9452555 fax
An Employee -Owned Company
TO Cov(>ala 6”-^421 6"a; Ozg4
ATTN ANnw-L
FAX NO.
We are sending the following:
SHEET OF
DATE IOl4/0S
❑ ENGLEWOOD, CO
14 Inverness Drive East
Suite F-120
Englewood, CO 80112
303.925.0544 phone
303.925.0547 fax
SUBJECT Loo 9 Nn icr-c
JOB NO. 7-64 io94'00
I
tE5P7 J,,,seecf-liti I214Y..-
-83"xlln
S+e' 6-.01 s:recti
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nAnriGC&Ej►'
OCT 0 4 2005
NED
u •
BUI DIN
�Ntu�
If material received is not listed above, kindly notify us at once.
Transmitted by:
o First Class Mail
❑ UPS Next Day Air
❑ Federal Express
❑ U.S. Express Mail
❑ UPS Standard Service
❑ Courier
❑ Pickup
El FAX
HCE Hand Deliver
By: is
CIVIL ENGINEERING
October 4, 2005
Garfield County
Building and Planning
108 W. 8's Street
Glenwood Springs, CO 81601
An Employee -Owned Company
Re: Lot 9 -Native Springs Subdivision
HCE Project Number 2041044.00 x 0218
To Mark Bean:
LAND SURVEYING
The following letter is to confirm the engineer's inspection of the revised septic system for Lot 9 of
the Native Springs Subdivision. High Country Engineering's field inspector performed the field
inspections. The design included a 1,250 gallon septic tank and an absorption field consisting of 33
infiltrator units configured in 3 rows of 11 units in a trench system. The ISDS system was relocated
from the design to locate the absorption trenches in the location of the observed profile pit. The
septic tank was installed to the rear of the house. The house line, effluent line, and manifold piping
was adjusted accordingly. We anticipate that these revisions will have no adverse impact to the
functionality of the system. Location of the installed system is shown as approximate as no swing
ties were provided. The final grading was not completed at the time of ISDS inspection, however
the owner is aware that drainage away from the absorption trenches must be provided when
completing the grading.
If you have any questions, or need additional information, please contact us.
Sincerely,
HIGH COUNTRY ENGINEERING, INC.
Daniel Dennison, P.E.
Project Manager
1517 Blake Avenue, Suite 101
Glenwood Springs, CO 81601
970.945.8676 phone
970.945.2555 fax
gt tea 'Po Ch
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www.hceng.com
RECD; ' D
OCT 0 4 2035
GAR' ...._ rY
BUILUiNG a PLRN\!NG
14 Inverness Drive East, Suite F-120
Englewood, CO 80112
303.925.0544 phone
303.925.0547 fax
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TRENCH LATERALS SHALL FOLLOW CONTOURS.
INSTALL INFILTRATOR IN ACCORDANCE WITH MANUFACTURER'S RECOMMENDATIONS.
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TABLE II
TABLE OF MINIMUM HORIZONTAL DISTANCES IN FEET BETWEEN COMPONENTS OF A SEWAGE DISPOSAL SYSTEM
INSTALLED AFTER NOVEMBER 15, 1973 AND PERTINENT PHYSICAL FEATURES
NOTE: The minimum distances shown above shall be maintained between the system components and the physical features descnbed Where soil, geological or other conditions
warrant, greater distances may be required by the local board of health or by the Water Quality Control Commission pursuant to C.R.S. 25-8-206 in accordance with the authority
prescribed by law and rules and regulations unplemental of said section. Components which are not watertight should not extend lido areas of the root system of nearby trees. For
repair or upgrading of canting systems where the size of lot precludes adherence to these distances, repaired facility shall not be closer to water supply components than the
existing facilities
(I) Distance shown shall not apply to treatment plants or effluent Imes where recycling is permitted.
(2) Crossings or encroachments may be permitted at the points as noted above provided that the water conveyance pipe is encased for a minimum distance of ten (10) feet
on each side of the crossing. A length of pipe shall be used with a minimum Schedule 40 rating of sufficient diameter to easily elide over and completely encase the
water conveyance Ridged end caps of at least Schedule 40 rating must be glued or secured in a watertight fashion to the ends of the encasement pipe. A hole of
sufficient ane to accommodate the pipe shall be dnlled in the lowermost section of the ridged cap so that the conveyance pipe rests on the bottom of the encasement
pipe. The area in which the pipe passes through the endcaps shall be sealed with an approved underground sealant compatible with the piping used.
(3) Add 8 fat additional distance for each 100 gallons per day of ddigo Row over 1000 gallons per day as specified m the table, unless it can be demonstrated by a
registered Professional Engineer or Geologist that a mechanical or natural barrier will prevent contamination.
(4) Encroachments may be permitted provided the water or wastewater conveyance pipe is encased as in (2) above, specified in the table.
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Dispersal System Utilizing
Aerosol Methods
Seepage Pit or Slit Trench
Absorption Trench, Seepage
Bed, Sand Filter, Sub -surface
Dispersal System, or Drywall
Unlined Sand Filter in Soil
With a Percolation Rate
Slower than 60 Minutes per
Inch
Unlined or Partially Lined
Evapotranspiration System.
Wastewater Pond, or Surface
Disposal System Other than
Aerosol
Lined Sand Filter
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2
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Pit Privy or Vault Pnvy
Septic Tanks, Treatment
Plants, Dosing Tanks, Vaults
Building Sewer or
Effluent Lines
NORTH
ERING, INC.
NGIJEWOOD, CO 80112 I3)9250547
OD SPRINGS, CO 81601
0) 9452555
DRAWN BY.
JAO
CHECKED BY.
REW
DAT::
1-17-05
FOE:
ISDS
NO.
DATE
REVISION
BY
CALL UTILITY NOTIFICATION
CENTER OF COLORADO
1-800-922-1987
OR 534-067001N METRO DENVER
CALL 2 -BUSINESS DAYS IN ADVANCE
BEFORE YOU DIG, GRADE, OR
EXCAVATE FOR THE MARKING OF
UNDERGROUND MEMBER UTLRIES
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